Complications of Encrusted Stents in Recurrent Nephrolithiasis: A Case Report

TL;DR

A case report shows how encrusted stents and recurrent kidney stones worsen chronic kidney disease, requiring timely surgical and multidisciplinary management.

Contribution

This case report emphasizes the importance of early intervention for encrusted stents and recurrent stones in CKD patients.

Findings

Encrusted stents and recurrent stones led to significant renal impairment in a CKD patient.

Surgical interventions like nephrolithotomy improved renal function and prevented further complications.

Stone analysis revealed struvite and uric acid stones linked to infections and metabolic factors.

Abstract

Chronic kidney disease (CKD) and recurrent nephrolithiasis can lead to significant renal impairment due to obstruction, infections, and direct damage from stones. Timely intervention is crucial to prevent further deterioration, especially in patients with poorly controlled diabetes and encrusted stents. We present a 56-year-old male with poorly controlled type 2 diabetes and stage 3 CKD. He had recurrent nephrolithiasis and initially underwent ureteral stenting, followed by a second stent placement due to pyelonephritis and significant encrustation. Imaging revealed a large bilateral calculous mass. The patient initially underwent nephrolithotomy with spectrophotometric analysis of the stones and had a favorable postoperative outcome. This case highlights the impact of untreated stents and recurrent stones in CKD patients. Encrusted stents can cause hydronephrosis, secondary obstruction, and increased renal pressure, contributing to renal function decline. Surgical intervention, including nephrolithotomy and ureterolithotomy, can improve renal function and prevent further complications. Spectrophotometric analysis of the stones revealed struvite and uric acid stones, both linked to infections and metabolic factors. Early stone removal and management of encrusted stents are essential in CKD patients with recurrent nephrolithiasis. A multidisciplinary approach is necessary to optimize treatment and prevent further renal deterioration. Regular follow-up is critical to avoid irreversible renal damage.

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